PubMed Health⌕ Search

Biomedical subjects

K R Sundaram

Publications and source records attributed to K R Sundaram.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence of known and undetected diabetes and associated risk factors in central Kerala--ADEPS.

Amrita Diabetes and Endocrine Population Survey (ADEPS) was conducted as a community-based cross-sectional survey to assess the prevalence of undetected diabetes mellitus (DM) and impaired glucose tolerance (IGT) and their possible relationship with various risk factors in an urban South Indian population. An initial house-to-house survey of adults between ages 18 and 80 years (n = 3069) was followed by a second phase consisting of health check-up and biochemical evaluations of participants (n = 986). DM and IGT were diagnosed as per WHO criteria. Reported prevalence of known diabetes mellitus in the survey was 9.0% (276/3069); (M-8.7% and F-9.2%). Among the screened subjects who underwent blood testing, the prevalence of newly diagnosed diabetes was 10.5%. The prevalence of IGT was 4.1% and IFG was 7.1%. Increasing age, obesity, positive family history of diabetes, abnormal subscapular triceps skin fold ratio and presence of acanthosis nigricans (AN) were all found to be associated with increased risk of DM. The finding of high prevalence of newly detected DM and IGT in this population of Kerala with the highest standards of health care and literacy level compared to other states of India, emphasizes the need for routine screening of high-risk groups for early detection of the disease. A simple cutaneous sign, acanthosis nigricans was independently associated with increased risk of type 2 diabetes in this survey and can be used as indication for screening for DM and IGT.

Adult↗
PubMed2001

Tonsillar actinomycosis: a clinicopathological study.

Actinomycosis has been known to involve virtually every anatomic site in the body. Although actinomycosis has been identified in resected tonsils, its possible role in adeno-tonsillar disease has received little attention. A clinicopathological study of 302 patients who had adeno-tonsillar surgery is presented. Tonsillar actinomycosis was present in 86 (28.5%) patients. The statistical analysis revealed a significant association (P<0.0001) of actinomycosis and tonsillar hypertrophy (56.8%) compared to only 10.3% in the recurrent tonsillitis group. A statistically significant association (P<0.0001) of tonsillar actinomycosis and sickle cell anaemia, beta thalassaemia, bronchial asthma and beta haemolytic streptococcal infections was also seen. This data supports a predisposition of the above conditions to tonsillar actinomycosis and adeno-tonsillar hypertrophy and a possible etiopathologic role of this organism in adeno-tonsillar hypertrophy and disease. Although the clinical association of actinomycosis and tonsillar hypertrophy and beta haemolytic streptococcal infection has been described before the association of actinomycosis with sickle cell anaemia, beta thalassaemia and bronchial asthma is being observed for the first time in literature.

Actinomyces↗
PubMed2001

National Family Health Survey and children.

This article aims to describe the National Family Health Survey (NFHS) being carried out in India with its first round during 1992-93 (NFHS-I) and second round during 1998-99 (NFHS-II), with special reference to information available in relation to children. The survey was on lines of the existing systems of Demographic Surveys (DHS) in various developed as well as developing countries. Another important objective of the survey was to provide quality data to the researchers to carry out analytical work on various aspects. Further, the survey has paved the way to carry out comparative studies not only between states in India but also between countries. An attempt has also been made here to present salient features of comparative results under NFHS-I and NFHS-II.

Child↗
PubMed2000

Factors predicting the non-utilisation of immunisation services using logistic regression technique.

A cross sectional study was conducted to determine the variables which have an individual predictive power on nonutilization of immunisation services using logistic regression model. Children between 12 and 23 months of age were assessed and enrolled using a pretested interview schedule. Statistical analysis was done using descriptive statistics, univariate analysis using Chi Square tests and multivariate logistic regression analysis. Of the 200 children studied 56% were fully immunised. Only illiterate mothers (p < 0.05) and poor access (> 3 km) to health facility (p < 0.001) were found to have an independent predictive power on the nonutilization of immunisation services. Sex of the child, parity levels, socioeconomic status did not independently influence the utilisation pattern. It is possible to identify these still existing small pockets of nonusers of immunisation services through the predictive variables and target them through special efforts.

Health Services Accessibility↗
PubMed2000

Epidemiological models and related simulation results for understanding of contraceptive adoption in India.

BACKGROUND: For the first time, models using multilevel analysis of Indian data and related simulation results are reported. They take hierarchical structure into account and incorporate variables from all levels to get correct analysis and proper interpretation of data on current contraceptive use (including sterilization and modern methods). METHODS: The data from an Indian State, Uttar Pradesh (UP), collected by the National Family Health Survey (NFHS) conducted during 10 October 1992 to 22 February 1993 was used. For model I, 7851 currently married women who were neither pregnant nor had continuing post-partum amenorrhoea (PPA) were considered. For model II, these women with at least one child (n = 6748) were used. Two-level logistic regression analysis was carried out for which women's level (level 1) and PSU (Primary Sampling Unit) level (level 2) variables were considered. The results were considered significant at the 5% level of significance. Simulation analysis using each model was also carried out. RESULTS: Model I reveals that those more likely to adopt contraception were women exposed to a TV message (odds ratio [OR] = 1.3; 95% CI: 1.1-1.6); whose houses were pucca (bricks and mortar) (OR = 1.3; 95% CI: 1.1-1.5); who were educated to high school level and above (OR = 2.9; 95% CI: 2.2-3.7); whose husbands were literate with schooling of > or =11 years (OR = 1.7; 95% CI: 1.4-2.1); and who had > or =2 living sons (OR = 2.2; 95% CI: 1.1-4.4). Muslim and other religious women were less likely than Hindu women to adopt contraception (OR = 0.5; 95% CI: 0.4-0.6). Also, the PSU level availability of all weather road was positively associated with contraceptive adoption (OR = 1.4; 95% CI: 1.1-1.7). The PSU level variance, which is the unexplained PSU level variation after controlling for the considered characteristics, was significantly higher. The simulation results revealed that public health education (a TV message) was found to be more effective among less educated women. The PSU level availability of all weather road was as effective as public health education. Similar results were evident from the analysis of second data set (model II) with the noticeable finding that those whose last child is surviving are most likely to adopt contraception (OR = 8.82; 95% CI: 1.01-77.38). CONCLUSIONS: These results reveal that the survival status of the last child has a marked effect on the adoption of contraception in UP. They further support the idea that public health education (a TV message) is more effective among less educated women. Also, the PSU level presence of all weather road is equally effective. Consideration of higher level variables provides not only more accurate results but also important public health clues to help the policy planners.

Adolescent↗
PubMed2000

Nutritional risk factors in esophageal cancer.

OBJECTIVE: The present case-control study was undertaken with the objective to study the nutritional risk factors associated with esophageal cancer. METHODOLOGY: One hundred and fifty diagnosed esophageal cancer patients and an equal number of healthy individuals constituted the patient and control groups, respectively. Dietary consumption pattern during the preceding 20 years prior to the diagnosis of esophageal cancer was assessed utilising the standard food frequency questionnaire method. Information on alcohol consumption, smoking habits, chewing of betel leaf with tobacco was also collected. RESULTS: Multivariate analysis revealed that the risk of esophageal cancer was 7.81 times (p < 0.01) higher with daily consumption of alcohol. The risk increased to 3.16 times (p < 0.01) with the daily habit of chewing of betel leaf with tobacco. Nearly a two fold risk was observed when the consumption of "other vegetables" was less than four times per week. A 1.95 times (p < 0.01) increase in risk was observed with the daily habit of bidi smoking. CONCLUSION: Cancers in general are multifactorial in origin, and several environmental interactions are possible. It is not easy to quantify the contribution of diet to cancer risk. However, the results of the present study suggested that nutritional factors do play a role.

Adult↗
PubMed1999

Monitoring oral iron therapy with protoporphyrin/heme ratios in pregnant women.

Assessment of the efficacy of iron therapy has usually been done in populations/patients by monitoring changes in hemoglobin concentration, serum iron, percent transferrin saturation, and serum ferritin. In this study the protoporphyrin heme (P/H) ratio (a measure of free erythrocyte protoporphyrin) was measured before and after iron therapy in three groups of pregnant women, who received 60 mg (group A), 120 mg (group B), and 240 mg (group C) of elemental iron with folic acid (0.5 mg) per day for a period of 12 weeks, to evaluate its efficacy to monitor iron therapy. The three groups were comparable regarding the initial mean Hb concentration and serum ferritin levels. The initial mean P/H ratios were markedly elevated in all three groups and were different in the three groups, being highest in group A (113.2+/-92.6), intermediate in group B (87.5+/-62.5), and lowest in group C (69.8+/-43.3). The initial P/H ratio was significantly higher in group A than in group C (p<0.05). This probably affected the efficacy of iron therapy in the three groups. The P/H ratio decreased significantly in each of the three groups after iron therapy (A and B: p<0.001; C p<0.01). Mean Hb concentration and serum ferritin increased in all three groups post therapy; however, the magnitude of change in P/H ratio in all three groups was much greater. This indicated that the predominant contributory factor for anemia was iron deficiency in this group of pregnant women. Serum iron and percent transferrin saturation are difficult to interpret in our population, as iron is freely available over the counter and is prescribed as soon as anemia is detected in patients; therefore, the reduction in P/H ratio may be used to monitor response to iron therapy in population groups.

Administration, Oral↗
PubMed1999

A controlled trial of alternative methods of oral feeding in neonates.

BACKGROUND: Some neonatal units are introducing use of cup and traditional feeding devices for feeding young infants although they have been not been evaluated objectively. Hence this controlled trial of the use of the bottle, cup and a traditional feeding device ('paladai') was undertaken in neonates. METHOD: The study comprised of 100 infants including full-term normal weight infants (n = 66), term growth retarded infants (n = 20), and preterm infants (n = 14). All three methods were tried on every infant by the same nurse for a particular baby, so that each infant served as his/her control and in order to avoid the effect of major influencing factors. Parameters evaluated were the volume ingested, duration of the feed, degree of spilling and satiety. RESULTS: The infants took the maximum volume in the least time and kept quiet longest with the paladai. The findings were particularly significant in the group including all the categories of infants. Spilling was the highest with the cup, especially with preterm infants.

Feeding Methods↗
PubMed1997

Rapid assessment of prevalence of cataract blindness at district level.

AIM: To find an optimal cluster size and number of clusters for a reasonable estimate of the prevalence of cataract blindness in people aged > or = 50 years in 19 rural districts of a state in India. MATERIALS: Cluster sampling methodology was used in 19 rural districts of Karnataka State, India. In each district, 15 clusters were randomly selected and 90 people aged > or = 50 years were examined in each cluster. As a result the visual acuity and lens status of a total of 22,218 people were assessed. METHODS: For each district, the design effect for cluster size ranging from 20 to 90 was calculated and the optimal cluster size and the required number of clusters to achieve an accuracy of 1% errors and 80% confidence was assessed. RESULTS: The age and gender adjusted prevalence of cataract blindness varied from 1.58% to 7.24%, which justifies district level surveys. The design effect is nearly 1.5 for clusters of sizes 30 and 40. With an average prevalence of 4.93% with 1% error and 80% confidence level, the optimal number of clusters is 37 and 28 for a cluster size of 30 and 40 respectively and the average sample size for a district around 1100. CONCLUSIONS: Rapid assessments for cataract blindness in those aged > or = 50 years can be conducted at district level in India with existing resources and at affordable costs. These provide reliable data, essential for effective monitoring and planning. Other parameters, for instance, surgical coverage can also be assessed. The availability of standardized software for data entry and analysis and strict adherence to survey procedures is essential.

Adult↗
PubMed1997

ESR and iron status in pregnancy.

ESR (Westergen) correlated significantly with the iron status (as measured by Hb concentration, haematocrit, red cell count, MCH, P/H ratio, serum iron, TIBC and percent saturation of transferrin) in a group of pregnant women (PW) at term. Serum ferritin correlated negatively with the ESR but the correlation was not statistically significant. Serum ferritin levels of < 50 micrograms/L were present in 9 (34.6%) PW with ESR > or = 50 mm 1st hour and 5 (19.2%) PW with ESR < 50 mm 1st hour. The mean ESR in PW was 55.7 (+/- 22.9) and was > or = 50 mm 1st hour in 50% and < 75 mm 1st hour in 82.7%. The difference in the mean ESR in anaemic and nonanaemic PW was highly significant (p < 0.001), 87.5% anaemic PW with serum ferritin > 50 micrograms/L had ESR > or = 50 mm 1st hour, suggesting the possible effect of chronic infection in raising ferritin levels in these PW.

Blood Sedimentation↗
PubMed1996

A randomized controlled trial of endoscopic variceal band ligation for primary prophylaxis of variceal bleeding.

OBJECTIVE: To assess the efficacy and safety of endoscopic variceal band ligation (EVL) for primary prophylaxis of variceal bleeding in patients with high-risk varices. DESIGN: A randomized, controlled trial. SETTING: Hospital based. SUBJECTS: Sixty-eight patients with portal hypertension with high-risk varices were randomized to undergo either EVL (n = 35) or no treatment (n = 33). INTERVENTIONS: Endoscopic variceal band ligation or no therapy. MAIN OUTCOME MEASURES: Probability of first variceal bleeding, probability of survival, variceal obliteration, complications of EVL. RESULTS: Oesophageal varices could be obliterated by EVL in 3.2 +/- 1.2 sessions within 4.9 +/- 2.2 weeks. Three (8.6%) patients in the EVL group and 13 (39.4%) in the control group bled during a mean follow-up of 14.1 +/- 5.0 months (range 2-22) (P < 0.01). The cumulative probability of the patients remaining free of bleeding was higher (P < 0.01) in the EVL group than the control. Variceal recurrence was seen in 10 (28.6%) patients and was managed by repeated EVL. None of the patients developed oesophageal stricture. Four (11.4%) patients in the EVL and eight (24.2%) in the control group died (P = NS). Bleed-related mortality was lower in the EVL than the control group (2.9% vs. 15.2%, P = 0.08). CONCLUSION: EVL significantly decreases the frequency of first variceal bleed. It should be evaluated further to see if bleeding-related mortality could be reduced in cirrhotics with high-risk varices who have not bled.

Adult↗
PubMed1996

Non-linear law-like relationship between weight & height of infants & pre-school children.

A non-linear equation of the type log w - 0.008 h = a - be-kl for weight (w) and height (h) of 1177 infants and pre-school children from the Rural Health Centre area in Ballabhgarh was fitted by modified Guass-Newton Method using BMDP 03R program. On applying the non-linear model to the data of the present study it was found that the curve was a good fit in both sexes and also in all nutritional groups. The value of 'a' (the nutritional index) was almost the same in boys and girls but it was higher in case of children with normal nutrition (0.37) and lower in children with malnutrition (0.34 in Grade I, 0.32 in Grade II and 0.28 in Grades III & IV). The exponential term 'k' (index of maturation) was higher in boys compared to that of girls and higher in those with normal nutrition than with malnutrition. It was found that the rate of decay of the exponential term was slower in those with malnutrition compared to those with normal nutrition. While no difference was observed in the asymptotic value i.e., the rate at which infants reach the shape of older children, between boys and girls with normal nutrition (19 and 20 months respectively), it was delayed by 5 to 8 months in girls compared to boys with malnutrition. In the total sample, the Ehrenberg's index attained the asymptotic value at 20 months in boys and at 35 months in girls and at 27 months in the combined sample.

Body Height↗
PubMed1994

Naloxone-induced withdrawal in patients with buprenorphine dependence.

Naloxone-induced withdrawal was studied in seven patients currently dependent only on injecting buprenorphine, within 3 to 6 hours of their last dose. Withdrawal severity began to rise from 5 minutes and reached a peak at 60 minutes after 1.2 mg naloxone given intravenously. The mean withdrawal severity score was significantly higher at 30, 60 and 90 minutes compared to the baseline. The most frequent withdrawal signs and symptoms were mydriasis, systolic hypertension, tachypnoea, muscle pains, yawning, anxiety, restlessness and craving.

Adolescent↗
PubMed1994

Prognostic role of screening tests of haemostasis and underlying diseases in acute disseminated intra-vascular coagulation in adults.

The significance of precipitating causes of acute disseminated intra-vascular coagulation (DIC) and the severity of derangement of haemostasis based on laboratory investigations carried out initially were evaluated in 98 patients and was related to the fatal outcome in them. It was seen that septicaemia was the commonest precipitating cause. Survival was better in patients in whom DIC was precipitated by obstetric causes compared with those with septicaemia (P < 0.01). Death was also more frequently associated in patients with higher prothrombin time (PPT) ratio (> 1.5) and/or higher activated partial thromboplastin time (APTT) ratio (> 2.5) as compared to their lower values (P < 0.01 each). Death occurred in all the seventeen patients in whom septicaemia was present along with PPT ratio of > 1.5. It is concluded that deranged haemostasis and presence of septicaemia both independent of each other, contribute to the fatal outcome in acute DIC. Combination of both is associated with poorest prognosis.

Acute Disease↗
PubMed1994

Blood pressure profile, urinary sodium and body weight in the 'Oraon' rural and urban tribal community.

Blood pressure and nutritional profiles in the 'Oraon' tribal community of India living in rural and urban areas were studied between 1981-85 after a house to house survey of 4523 rural tribal people (RT) and 935 of their urban tribal counterparts (UT). Prevalence of hypertension was found to be 4.8/1000 males and 4.3/1000 females in rural tribal group giving an overall rate of 4.6/1000. In contrast the same were 27.1/1000 males and 21.4/1000 females in UT group, overall rate being 25.6/1000. Average calorie consumption were 1750 and 2280 and mean 24 hour-urinary sodium excretions 58 and 118 milliequivalents in RT and UT groups respectively. Of the total of 21 subjects in RT and 24 in UT detected to be hypertensive, 7 had common family inheritance. Increased mean arterial pressure correlated with increased sodium consumption and body weight. Hypertensives from both the groups showed higher urinary sodium excretion (P < 0.05). This epidemiologic study proves the role of a genetic factor/defect complicated by higher salt consumption in causation of increased blood pressure.

Adult↗
PubMed1994

Are diarrheal incidence and malnutrition related in under five children? A longitudinal study in an area of poor sanitary conditions.

This study was conducted in Atali and Garkhera villages of Faridabad district of Haryana to assess the relationship between diarrheal incidence and malnutrition. Two hundred and fifty children in the age group of 6-47 months were followed up for one year from June 1988. History of diarrheal episodes was ascertained by fortnightly home visits. Nutritional status (weight for age) of the children was assessed at the beginning of the study and at every four monthly interval. The mean diarrheal incidence was 2.88 +/- 1.28 episodes per child year. The pre-valence of moderate to severe malnutrition in the children was 35% out of which 8.8% were severely malnourished. Although severely malnourished children had 0.56 more episodes of diarrhea in a year compared to normally nourished, the difference was not statistically significant. Similarly, number of episodes of diarrhea also did not affect the subsequent nutritional status of the children. The possible reason for this could be that in areas of poor sanitary conditions, nutritional status may not play an important role in increasing the susceptibility of children to diarrhea.

Child, Preschool↗
PubMed1994

A study of the etiological factors associated with the development of malocclusion.

The prevalence of malocclusion among 1608 children (777 boys and 831 girls) in the age group of 5-7 years, selected from different schools of varied locations of Delhi was observed as 18.4%. A number of factors that could influence the normal development of occlusion during early mixed dentition stage were recorded. These included spacing in anterior teeth, attrition of primary teeth and deleterious oral habits. The socio-demographic variables included occupation of parents, family size, location type and the school type. The age of the child and sex were also considered. In order to find out the contribution and importance of above mentioned occlusal characteristics and socio-demographic factors in the development of malocclusion, the data were subjected to univariate analysis. Further a stepwise logistic regression analysis was done to know whether any association exists between the occurrence of malocclusion and combination of these factors. Four factors were found to contribute significantly in the occurrence of malocclusion explaining 15.5% variation in case of boys and 22% in case of girls. More significant factors were absence of spacing, effect of habits and lack of attrition of primary teeth. About 80% of the total variation was independent of these factors and could not be explained by this analysis. It further testifies possible predominance of genetic influences in the development of occlusion.

Adolescent↗